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EP2095785B1 - Instrument électrochirurgical bipolaire doté d'électrodes remplaçables - Google Patents

Instrument électrochirurgical bipolaire doté d'électrodes remplaçables Download PDF

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Publication number
EP2095785B1
EP2095785B1 EP09160476.9A EP09160476A EP2095785B1 EP 2095785 B1 EP2095785 B1 EP 2095785B1 EP 09160476 A EP09160476 A EP 09160476A EP 2095785 B1 EP2095785 B1 EP 2095785B1
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EP
European Patent Office
Prior art keywords
instrument
electrodes
jaw
seal surface
handle
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP09160476.9A
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German (de)
English (en)
Other versions
EP2095785B8 (fr
EP2095785A1 (fr
Inventor
Dale Francis Schmaltz
Robert Luzzi
David Nicholas Heard
Steven Paul Buysse
Kate Ryland Lawes
Daniel Lee Ii Trimberger
Mathew Erle Mitchell
Jenifer Serafin Kennedy
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien AG
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Covidien AG
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Publication date
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Publication of EP2095785B1 publication Critical patent/EP2095785B1/fr
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Publication of EP2095785B8 publication Critical patent/EP2095785B8/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2945—Curved jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00404—Blood vessels other than those in or around the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00619—Welding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • A61B2018/1432—Needle curved
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/146—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1495—Electrodes being detachable from a support structure

Definitions

  • This invention relates to a bipolar electrosurgical instrument, and more particularly to a bipolar electrosurgical instrument having replaceable electrodes for sealing vessels and vascular tissue.
  • a hemostat is commonly used in surgical procedures to grasp, dissect and clamp tissue. It is typically a simple pliers-like tool that uses mechanical action between its jaws to constrict vessels without cutting them. It is also typical to have an interlocking ratchet between the handles so that the device can be clamped and locked in place.
  • hemostats are used in a typical open-surgical procedure. Once vascular tissue has been clamped with a hemostat, it is common for a surgeon to tie a suture around the tissue to close it off permanently prior to removing the hemostat. Several hemostats may be left in the surgical field until the surgeon has the opportunity to tie a suture around each section of clamped tissue.
  • bipolar instruments to coagulate vessels in the brain that are smaller than two millimeters in diameter. These bipolar instruments are typically tweezers-like devices with two arms that can be deflected toward each other to grasp tissue. However, it has been found that these instruments are not capable of sealing blood vessels with diameters larger than about two millimeters. There has been a long-felt need for an easy way to seal larger vessels and vascular tissue bundles without the need for sutures.
  • Coagulation is defined as a process of desiccating tissue wherein the tissue cells are ruptured and dried.
  • Vessel sealing is defined as the process of liquefying the collagen in the tissue so that it crosslinks and reforms into a fused mass.
  • coagulation of small vessels is sufficient to permanently close them. Larger vessels need to be sealed to assure permanent closure.
  • a U.S. Patent 5776130 discloses another surgical tool for sealing vessels.
  • U.S. Patent 371,664 discloses a pair of electric forceps with positive and negative electric poles located on the jaws.
  • U.S. Patent 728,883 discloses an electrothermic instrument in which electricity is used to heat one of the jaws of the instrument.
  • U.S. Patent 1,586,645 discloses a bipolar instrument for coagulating tissue.
  • U.S. Patent 2,002,594 discloses a bipolar laparoscopic instrument for treating tissue, whereby coagulation and cutting of tissue can be performed with the same instrument.
  • U.S. Patent 2,176,479 discloses an instrument for finding and removing metal particles.
  • the jaws of the instrument are designed to complete an electrical circuit when conductive material is placed therebetween.
  • An insulated pivot and an insulated ratchet are used to prevent a short circuit.
  • U.S. Patent 3,651,811 discloses a bipolar electrosurgical instrument for cutting and coagulating tissue.
  • U.S. Patent 4,005,714 discloses bipolar coagulation forceps with jaws that open and close by way of an actuating sleeve
  • U.S. Patents 4,370,980 and 5,116,332 disclose an electrocautery hemostats wherein the hemostatic clamping function and the electrocautery function may be accomplished with a single instrument. Monopolar electrosurgical designs are shown and described.
  • U.S. Patent 4,552,141 discloses a family of removable switch electrocautery instruments, including an electrocautery hemostat. Monopolar electrosurgical designs are shown and described.
  • U.S. Patent 5,026,370 discloses an electrocautery forceps instrument having an enclosed electrical switching mechanism. Monopolar electrosurgical designs are shown and described.
  • the preamble of claim 1 is based on this document.
  • U.S. Patent 3,443,463 discloses coagulating forceps having a plurality of electrodes.
  • U.S. Patent 5,484,436 discloses bipolar electrosurgical instruments for simultaneously cutting and coagulating tissue.
  • Russian Patent 401,367 translation enclosed, discloses a bipolar instrument with a linkage that brings the working jaws together in a parallel manner.
  • Prior disclosures have not provided a design for a bipolar electrosurgical instrument with removable electrodes capable of conveniently applying a constant pressure, from a calibrated spring-loaded source held by a ratchet, that is sufficient to seal vessels and vascular tissue.
  • a bipolar electrosurgical instrument for sealing vessels and vascular tissue.
  • the instrument is designed to grasp and clamp vessels or vascular tissue between its jaws.
  • the jaws have removable electrodes that are electrically connected to an electrosurgical generator. Electrosurgical current flows through the clamped tissue between the electrodes.
  • the instrument is bipolar because electrosurgical current flows from one electrode, through the tissue, to another electrode, and both electrodes are located on the instrument.
  • a monopolar instrument requires a separate electrode (sometimes called an "neutral electrode,") that is located remote from the instrument.
  • vessels and vascular tissue can be sealed without the use of sutures, staples, or other material that is foreign to the tissue.
  • the removable electrodes provide safety against electrical shocks and bums. Electrically insulative materials, such as plastics, can be damaged or compromised by repeated sterilization cycles. It is also possible for electrical insulation to be cut or nicked by sharp surgical tools. Removable electrodes provide a safety advantage because they can be replaced prior to each procedure. The electrodes can also be replaced at any time if the surgeon suspects an electrical insulation failure. This advantage is particularly important for vessel sealing instruments because currents up to 4 amperes may be used.
  • the bipolar electrosurgical instrument comprises first and second members having first and second jaws near a distal end, and having first and second handles near a proximal end.
  • a pivot joint connects the first and second members to allow for arcuate motion of the first and second jaws toward each other.
  • First and second mechanical interfaces are located respectively on the first and second jaws.
  • the first and second mechanical interfaces are preferably shaped to removably male with first and second electrodes.
  • the mating portion of the electrodes are made from an insulative material to prevent electrical conduction to the members.
  • Seal surfaces on the opposable electrodes are preferably designed to clamp vessels and vascular tissue and conduct electrosurgical current therethrough in a bipolar circuit.
  • First and second interlocking ratchets are located on the proximal end of the members to provide a constant closure force between the seal surfaces.
  • a bipolar electrosurgical instrument 10 is shown with replaceable electrodes 11 and 12 for sealing vessels and vascular bundles.
  • the instrument 10 comprises a first member 13 and a second member 14 that are connected at a pivot joint 15.
  • Handles 16 and 17 are located generally at the proximal end 18.
  • Jaws 19 and 20 are located generally at the distal end 21.
  • Sockets 22 and 23 are located on the jaws 19 and 20.
  • the sockets 22 and 23 each preferably comprise several features, as shown in Figure 2 at the location where the electrode 11 is removed.
  • the jaws 19 and 20 are straight.
  • the jaws 19 and 20 may be curved to accept curved electrodes 11 and 12, as shown in Figure 4 .
  • the first and second electrodes 11 and 12 are removably mounted respectively in the first and second sockets 22 and 23. While the term socket is used herein, it will be understood that either a male or female mechanical interface may be used on the jaws 19 and 20, with a mating mechanical interface on the electrodes 11 and 12.
  • a male or female mechanical interface may be used on the jaws 19 and 20, with a mating mechanical interface on the electrodes 11 and 12.
  • Figure 2 one of the sockets 22 is shown with the electrode 11 removed.
  • Figure 3 shows the socket 23 with an electrode 12 mated therein.
  • Each of the first and second electrode 11 and 12 has an electrically conductive seal surface 24 and an electrically insulative substrate 25, as shown in Figures 5 and 7 .
  • Each substrate 25 is shaped to engage one of the first or second sockets 22 or 23 with mating features that fit removably within the sockets 22 or 23.
  • the seal surfaces 24 are relatively flat to avoid current concentrations at sharp edges, and to avoid arcing between high points.
  • First and second wires 26 and 27 are connected to the first and second electrodes 11 and 12, respectively, as shown in Figures 1 , 4. 5, and 7 .
  • the wires 26 and 27 are bundled together along one of the members 13 or 14 from the proximal end 18 to the pivot 15. Near the pivot 15, the wires 26 and 27 are separated and connected each to its respective electrode 11 or 12.
  • This arrangement of wires 26 and 27 is designed to be convenient for the surgeon so that there is little interference with the manipulation of the instrument 10.
  • the wires 26 and 27 are preferably terminated in a connector 28 near the proximal end 18, although in another embodiment the wires 26 and 27 may extend all the way to an electrosurgical generator.
  • the wires 26 and 27 each extend along a separate handle 16 or 17.
  • First and second ratchets. 29 and 30. are located on the members 13 and 14 near the handles 16 and 17, as shown in Figures 1 , 2 , nd 3.
  • the ratchets 29 and 30 interlock in at least one position, shown in Figure 1 at 31 . In the preferred embodiment, there are several interlocking positions.
  • the ratchet position 31 holds strain energy in the first and second members 13 and 14 to force the electrodes 11 and 12 against each other in opposition.
  • Each member 13 and 14 is designed to deflect in a shank portion, defined as the section between the pivot 15 and the location of the ratchet.
  • the jaws 19 and 20 are preferably more rigid than the shank portions.
  • a lateral deflection of the shank portion causes strain due to bending that behaves like a spring.
  • the strain energy that is stored in the shank provides a constant closure force between the electrodes 31 and 12.
  • a design without a ratchet requires the surgeon to hold the electrodes together by applying a constant squeeze to the handles. It has been found through experimentation that a constant force throughout the sealing process will yield a more predictable surgical outcome. It is difficult to hold a constant force by hand, therefore a ratchet in combination with a deflectable shank will provide a better surgical outcome.
  • the electrically insulative substrate 25 on each of the electrodes 11 and 12 is preferably made from an injection moldable plastic.
  • the substrate 25 is preferably overmolded to capture the electrically conductive seal surface 24, as shown in Figure 8 .
  • Wires 26 and 27 are electrically connected to the seal surface 24 of each electrode 11 or 12.
  • the substrate 25 preferably comprises a forked snap fit extension 32 as shown in detail in Figure 6 .
  • Each jaw 19 and 20 has a socket 22 and 23 that comprises a recess 34, shown in Figure 9 , shaped to capture the forked snap fit extension 32.
  • One of the advantages of this design is that manufacturing tolerances can be accommodated by the snap fit as shown in Figure 11 .
  • the preferred embodiment also comprises a pair of alignment pins 34 and 35 that fit into the sockets 22 and 23.
  • the instrument 10 is designed so that the electrodes 11 and 12 meet in parallel opposition.
  • opposing seal surfaces 24 meet each other in the same plane, as shown in Figure 1 .
  • the seal surfaces can be slightly biased to meet each other at the distal end, and further closure force at the handles will cause the seal surface 24 on each electrode 11 and 12 to deflect together in the same plane.
  • Other embodiments have an insulative element on each jaw that opposes the conductive seal surface 24 on the opposing jaw, such that the instrument 10 does not short circuit when the jaws 19 and 20 are closed together.
  • the closure force between the seal surfaces 24 is preferably sufficient to overcome a tendency of the tissue to expand during heating.
  • the sealed tissue thickness must be less than the initial tissue thickness, under pressure, in order to create a fused vessel wall.
  • the amount of pressure required depends on the type of tissue, and the dimensions of the seal surfaces 24, and the size of the tissue that is grasped with the instrument 10. The pressure is expressed herein as a formula depending on the width of the seal surface and the closure force between the seal surfaces.
  • each seal surface 24 has a width that is preferably in the range of 2 to 5 millimeters, and a length in the range of 10 to 30 millimeters.
  • experimental results indicate that good vessel sealing performance can be achieved when the instrument 10 is calibrated to have at least one ratchet position 31 set such that the closure force (in grams) divided by the width of the seal surface (in millimeters) is in the range of 400 to 650, and most preferably 525.
  • an instrument with a seal surface width of 4 miliimeters would preferably have a closure force of 2100 grams.
  • the closure force in grams
  • the width of the seal surface in millimeters
  • the closure force in grams
  • the width of the seal surface in millimeters
  • Such an instrument would also preferably have a cross hatched or knurled seal surfaces 24 to improve grasping capability, but the height of the roughness features should be minimized to avoid arcing.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
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Claims (13)

  1. Instrument électro-chirurgical bipolaire (10) comprenant :
    un premier élément (13) ayant une première mâchoire (19) près d'une extrémité distale de l'instrument, et ayant une première poignée (16) près d'une extrémité proximale de l'instrument ;
    un deuxième élément (14) ayant une seconde mâchoire (20) près de l'extrémité distale et ayant une seconde poignée (18) près de l'extrémité proximale ;
    un joint de pivotement (15) reliant les premier et deuxième éléments pour permettre un mouvement arquée des première et seconde mâchoires l'une vers l'autre ;
    des première et seconde électrodes (11, 12) disposées dans les première et deuxième mâchoires respectivement ; caractérisé par :
    un premier rochet (29) sur la première poignée, et un deuxième rochet (30) sur la seconde poignée ;
    des premier et deuxième fils (26) connectés aux première et seconde électrodes, respectivement ;
    une première interface mécanique (23) sur la première mâchoire, et une deuxième interface mécanique (22) sur la seconde mâchoire ;
    les première et seconde électrodes étant installées d'une manière amovible dans les première et deuxième interfaces mécaniques, respectivement, où chacune des première et deuxième électrodes inclut une surface d'obturation électriquement conductrice (24) et un substrat électriquement isolant (25), où chaque substrat est configuré, de préférence d'une manière relâchable, pour venir en prise avec une des première et deuxième interfaces mécaniques ;
    où chacun des premier et deuxième éléments est configuré pour défléchir dans une portion de tige de celui-ci, définie comme une section entre le joint de pivotement et un emplacement des premier et deuxième rochets, respectivement, à la manière d'un ressort pour y stocker l'énergie de déformation afin de réaliser une force de fermeture constante entre les première et seconde électrodes.
  2. Instrument selon la revendication 1, dans lequel la première interface mécanique comprend une première douille située sur la première mâchoire, et la seconde interface mécanique comprend une deuxième douille située sur la seconde mâchoire, où chaque substrat inclut une propriété appariée (32, 34, 35) configurée pour la mise en prise avec une douille respective des première et deuxième douilles, où les propriétés appariées s'ajustent d'une manière amovible dans les première et deuxième douilles.
  3. Instrument selon la revendication 2, dans lequel la propriété appariée de chaque substrat isolant inclut une extension à enclenchement fourchée (32), et où chacune des première et seconde interfaces mécaniques possède un évidement configuré pour capturer l'extension à enclenchement fourchée.
  4. Instrument selon l'une quelconque des revendications 2 ou 3, dans lequel la propriété appariée de chaque substrat isolant comprend une paire d'axes d'alignement (34, 35), et où chacune des première et seconde interfaces mécaniques possède une paire d'évidements configurés pour la mise en prise avec une paire d'axes d'alignement.
  5. Instrument selon l'une quelconque des revendications précédentes, dans lequel les premier et deuxième fils sont fixés d'une manière amovible à la première poignée.
  6. Instrument selon l'une quelconque des revendications précédentes, dans lequel les surfaces d'obturation sont sollicitées pour se rencontrer à l'extrémité distale, et une force de fermeture additionnelle aux poignées amènera la surface d'obturation sur chaque électrode à défléchir ensemble dans le même plan.
  7. Instrument selon l'une quelconque des revendications précédentes, dans lequel chaque surface d'obturation a une largueur, et la force de fermeture en grammes divisée par la largueur en millimètres est dans la plage de 400 - 650.
  8. Instrument selon l'une quelconque des revendications 1 à 6, dans lequel chaque surface d'obturation a une largueur, et la force de fermeture en grammes divisée par la largueur en millimètres est dans la plage de 1000 - 2000.
  9. Instrument selon l'une quelconque des revendications précédentes, dans lequel l'électrode comprend un élément de décharge de traction (33).
  10. Instrument selon l'une quelconque des revendications précédentes, comprenant en outre un élément d'arrêt pour la création d'un espace fixe entre les première et deuxième électrodes.
  11. Instrument selon l'une quelconque des revendications précédentes, dans lequel chacune des première et seconde mâchoires est plus rigide que leurs portions de tige respectives.
  12. Instrument selon l'une quelconque des revendications précédentes, dans lequel les rochets s'interverrouillent dans au moins une position pour maintenir l'énergie de déformation dans les premier et second éléments pour forcer les électrodes l'une contre l'autre en opposition afin de réaliser une force de fermeture constante entre les surfaces d'obturation.
  13. Instrument selon l'une quelconque des revendications précédentes, dans lequel le substrat isolant est surmoulé pour capturer la surface d'obturation électriquement conductrice.
EP09160476.9A 1997-11-12 1998-11-11 Instrument électrochirurgical bipolaire doté d'électrodes remplaçables Expired - Lifetime EP2095785B8 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US08/968,496 US6050996A (en) 1997-11-12 1997-11-12 Bipolar electrosurgical instrument with replaceable electrodes
EP05013894A EP1586278B1 (fr) 1997-11-12 1998-11-11 Instrument électro-chirurgical bipolaire avec électrodes interchangeables
EP98957773A EP1032318B1 (fr) 1997-11-12 1998-11-11 Instrument bipolaire d'electrochirurgie a electrodes amovibles

Related Parent Applications (4)

Application Number Title Priority Date Filing Date
EP98957773.9 Division 1998-11-11
EP05013894A Division EP1586278B1 (fr) 1997-11-12 1998-11-11 Instrument électro-chirurgical bipolaire avec électrodes interchangeables
EP98957773A Division EP1032318B1 (fr) 1997-11-12 1998-11-11 Instrument bipolaire d'electrochirurgie a electrodes amovibles
EP05013894.0 Division 2005-06-28

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EP2095785A1 EP2095785A1 (fr) 2009-09-02
EP2095785B1 true EP2095785B1 (fr) 2014-01-08
EP2095785B8 EP2095785B8 (fr) 2014-02-26

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EP98957773A Expired - Lifetime EP1032318B1 (fr) 1997-11-12 1998-11-11 Instrument bipolaire d'electrochirurgie a electrodes amovibles
EP05013894A Expired - Lifetime EP1586278B1 (fr) 1997-11-12 1998-11-11 Instrument électro-chirurgical bipolaire avec électrodes interchangeables
EP09160476.9A Expired - Lifetime EP2095785B8 (fr) 1997-11-12 1998-11-11 Instrument électrochirurgical bipolaire doté d'électrodes remplaçables

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EP98957773A Expired - Lifetime EP1032318B1 (fr) 1997-11-12 1998-11-11 Instrument bipolaire d'electrochirurgie a electrodes amovibles
EP05013894A Expired - Lifetime EP1586278B1 (fr) 1997-11-12 1998-11-11 Instrument électro-chirurgical bipolaire avec électrodes interchangeables

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US (3) US6050996A (fr)
EP (3) EP1032318B1 (fr)
JP (1) JP4074746B2 (fr)
AU (1) AU736231B2 (fr)
CA (1) CA2310039C (fr)
DE (2) DE69835763T2 (fr)
ES (2) ES2268801T3 (fr)
WO (1) WO1999023933A2 (fr)

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Publication number Publication date
EP1032318B1 (fr) 2006-08-30
EP1586278B1 (fr) 2009-06-17
CA2310039C (fr) 2008-10-07
US6464704B2 (en) 2002-10-15
DE69840920D1 (de) 2009-07-30
WO1999023933A3 (fr) 1999-07-15
EP1586278A3 (fr) 2006-04-05
ES2328367T3 (es) 2009-11-12
ES2268801T3 (es) 2007-03-16
AU736231B2 (en) 2001-07-26
JP4074746B2 (ja) 2008-04-09
US7160298B2 (en) 2007-01-09
WO1999023933A2 (fr) 1999-05-20
EP2095785B8 (fr) 2014-02-26
JP2001522622A (ja) 2001-11-20
US20010037110A1 (en) 2001-11-01
EP1032318A4 (fr) 2001-09-19
AU1395299A (en) 1999-05-31
EP2095785A1 (fr) 2009-09-02
DE69835763D1 (de) 2006-10-12
EP1586278A2 (fr) 2005-10-19
DE69835763T2 (de) 2007-08-23
EP1032318A2 (fr) 2000-09-06
US6050996A (en) 2000-04-18
US20050004568A1 (en) 2005-01-06
CA2310039A1 (fr) 1999-05-20

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